Provider Demographics
NPI:1083632632
Name:BOBST, ELIZABETH V (LPCC, MED)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:V
Last Name:BOBST
Suffix:
Gender:F
Credentials:LPCC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2937
Mailing Address - Country:US
Mailing Address - Phone:513-871-2467
Mailing Address - Fax:
Practice Address - Street 1:5720 SIGNAL HILL CT STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1481
Practice Address - Country:US
Practice Address - Phone:513-831-9408
Practice Address - Fax:513-831-1333
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE7990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health